Comparison of four methods of cleaning hollow-fiber dialyzers for reuse

Four methods of cleaning hollow-fiber artificial kidneys (HFAKs) for reuse were compared in a prospective study. Each cleaning method was randomly assigned and HFAKs were reused until volume loss was greater than or equal to 15 ml, unless discarded for other reasons. HFAKs cleaned with 0.3 M sodium hydroxide averaged 14.5 uses, significantly better (p less than 0.01) than reverse ultrafiltration (6.4 uses), 3% hydrogen peroxide (5.7 uses), or water flush (4.7 uses). Only 1 of 10 HFAKs cleaned with NaOH was discarded owing to volume loss, whereas 25 of 30 HFAKs cleaned by the other methods were rejected for this reason. To relate changes in solute clearance to volume loss, urea and creatinine clearances were determined on HFAKs cleaned by water flush. By the fifth use the average volume had declined to 86.3% of original, but creatinine and urea clearances were reduced, respectively, to 97 and 95% of the original values.